Small Business Solutions Life and Disability Insurance Options

Transcription

1 Small Business Solutions Life and Disability Insurance Options North Carolina Underwritten by Aetna Life Insurance Company NC A (9/07)

2 Aetna Life and Disability The streamlined Life and Disability package includes a range of flat dollar insurance options bundled together in one monthly per employee rate resulting in a simplified quotation process. These products are easy to understand and offer affordable benefits with valuable services at no additional cost. Employers will also benefit from streamlined plan installation, administration and claims processing. Or, if a Life solution is all they re looking for, simply choose from our portfolio of Group Basic Term Life insurance plans. Life insurance customers have access to free investment planning services through an arrangement with Chase Bank, New York. The program is available to all beneficiaries regardless of their benefit payout and provides investment planning counseling from a Chase Financial Consultant through a toll-free number. Aetna s Legal Reference Program * offers free information on living wills and health care directives and access to basic will preparation services to plan members through an arrangement with ARAG, North America Inc. Life Insurance Life insurance is an inexpensive way to provide a death benefit for employees that will help them establish essential financial protection for themselves and their families. Aetna offers a wide range of flat dollar insurance options for basic employee term life insurance with rates guaranteed not to increase for a period of two years from the policy s effective date. Aetna Small Group life insurance plans automatically come with many value-added features including: Accelerated Death Benefits Also called the living benefit, provides payment to terminally ill employees or spouses. The payment can be up to 75% of the life insurance benefit (minimum of $5,000). Premium Waiver Provision Employee coverage may stay in effect up to age 65 without premium payments if an employee becomes permanently and totally disabled while insured because of an illness or injury prior to age 60. Guaranteed Issue For Basic Term Life, coverage is individually guaranteed issue up to $20,000 for groups with 2-9 eligible employees, $75,000 for groups of eligible employees and $100,000 for groups of eligible employees. For Packaged Life/Disability, the guaranteed issue amounts for groups of 2-50 eligible employees are $10,000 for the Low Option and $20,000 for the Medium Option. For the High Option, the guaranteed issue amount is $20,000 for groups of 2-9 eligible employees and $50,000 for groups of eligible employees. Optional Dependent Life Insurance Ability to add optional additional coverage for eligible spouses and children for employers with 10 or more employees. This employee paid benefit enables employees to cover their spouses and dependent children at flat amounts at employee expense. Aetna Beneficiary Solutions TM Program * A program that provides an interest-bearing account, customized investment programs with confidential, free financial counseling through Chase Bank, New York, as well as Aetna s Legal Reference Program for all beneficiaries. *For the Aetna Beneficiary Solutions Program, securities (including mutual funds and variable annuities) and investment advisory services are offered through Chase Investment Services Corp, (CISC) or affiliated broker/dealers. Annuities and insurance products are provided by various insurance companies and offered through Chase Insurance Agency, Inc. (CIA), a licensed insurance agency, doing business as Chase Insurance Agency Services, Inc. in Florida. CISC, a member of NASD/SIPC, and CIA are affiliates of JPMorgan Chase Bank, N.A. Products not available in all states. JPMorgan Chase Bank, N.A., and its affiliates do not offer legal or accounting advice to their clients. Clients are urged to consult with their own legal, accounting and tax advisors with respect to their specific situations. Aetna does not warrant or guarantee and makes no representations as to the quality of services offered by CISC. NOT A DEPOSIT. NOT FDIC INSURED. NOT INSURED BY ANY FEDERAL GOVERNMENT AGENCY. NOT GUARANTEED BY THE BANK. MAY GO DOWN IN VALUE. The Legal Reference Program is independently offered and administered by ARAG North America. Aetna does not participate in attorney selection or review, and does not monitor ARAG services, content (including web content) or network. Aetna does not provide legal services and makes no representations or warranties as to the quality of the information on the ARAG website, the services of ARAG or of any attorney in the ARAG network. Aetna does not credential or otherwise make any representations as to the quality or appropriateness of long-term care providers offering discounts to Aetna members. While this material is believed to be accurate as of the print date, it is subject to change.

3 Small Business decision makers can choose from a selection of affordable life and disability insurance solutions to meet their employees needs. We also provide extra value through a variety of services for their employees. AD&D Ultra Accidental Death and Personal Loss Coverage, called AD&D Ultra is automatically included in all employee term life plans and as part of the streamlined Life and Disability package. AD&D Ultra provides a benefit up to the amount of group life insurance for certain accidental losses. Aetna calls it AD&D Ultra because it includes a 365-day covered loss period and fourteen standard benefit features that set the standard for accidental loss protection. These benefits include: Death Dismemberment Loss of Sight Loss of Speech Loss of Hearing Third Degree Burns Paralysis Exposure and Disappearance Passenger Restraint & Airbag Education Benefit for Dependent Child and/or Spouse Child Care Benefit Coma Benefit Repatriation of Remains Benefit Total Disability Benefit Disability Disability insurance provides a partial replacement of lost income for the employee and helps reduce employer costs compared to the cost of carrying disabled employees on the payroll while also paying overtime to other employees or hiring replacements. Through Aetna Disability Services, plan administration is easy and dependable: Fast, accurate claim payments from our dedicated disability benefit system that automates benefit calculations, claim histories and audit and security features. Designated claim analysts who serve as the employee s single point of contact to our team of claim and clinical professionals. Nurse case managers and vocational rehabilitation specialists are available to work with employees facing complex clinical and functional challenges to help achieve a positive outcome for the employee and cost-effective claim management for the employer. We align clinical and claim management experience with the nature and complexity of each claim to provide the right touch at the right time for the employer and their ill or injured employees. Packaged Life and Disability Aetna offers a streamlined product that combines basic life, AD&D Ultra, dependent life and disability insurance coverages in one convenient package. To make it easy to choose, we ve designed three alternatives that provide different levels of life and disability coverage for a set price Low, Medium and High plans. These insurance plans offer a range of flat dollar insurance options bundled together in one monthly per employee rate. There are several advantages to choosing these options: One-stop shopping. Plans are designed to meet the business needs of small business owners. Simplified quotation process no extra information is needed and rates are set. Streamlined plan installation, administration and claims processing. Specially designed Disability product, which is a combination of Short and Long Term Disability benefits that at a crucial time helps employees bridge from most employer-sponsored salary continuation to Social Security. The Disability portion of this product offers coverage for occupational and non-occupational injuries and illnesses. For a summary list of Limitations and Exclusions, refer to page 5. 2

4 TERM LIFE BENEFITS AETNA SMALL GROUP BASIC EMPLOYEE TERM LIFE PLAN OPTIONS Available with an Aetna Medical Plan to Groups with 2-50 Eligible Available with an Aetna Dental Plan to Groups with Eligible Available Standalone (without Medical or Dental Plans) to Groups with Eligible Basic Life Schedule Flat $10,000, $15,000, $20,000, $50,000 Flat $10,000, $15,000, $20,000, $50,000, $75,000, $100,000, $125,000 Class Schedules Not Available Up to 3 classes (with a minimum requirement of 3 employees in each class) the benefit amount of the highest class cannot be more than 5 times the benefit amount of the lowest class even if only two classes are offered Premium Waiver Provision Premium Waiver 60 Premium Waiver 60 Age Reduction Schedule Original Life Amount reduces to 65% at age 65; Original Life Amount reduces to 65% at age 65; 40% at age 70; 25% at age 75. While the volume 40% at age 70; 25% at age 75. While the volume decreases the premium decreases but the rates decreases the premium decreases but the rates do not go down. do not go down. Accelerated Death Benefit Up to 75% of Life Amount for terminal illness Up to 75% of Life Amount for terminal illness Guaranteed Issue $20, employees $75, employees $100,000 Participation Requirements 100% 100% on non-contributory plans; 75% on contributory plans Contribution Requirements 100% Employer Contribution Minimum 50% Employer Contribution AD&D ULTRA AD&D Schedule Matches Matches Additional Features Passenger restraint and airbag, education Passenger restraint and airbag, education benefit for your child and/or spouse, benefit for your child and/or spouse, child care, repatriation of remains, coma, child care, repatriation of remains, coma, Total Disability, 365-day covered loss Total Disability, 365-day covered loss OPTIONAL DEPENDENT TERM LIFE Spouse Amount Not Available $5,000 Child Amount Not Available $2,000 DISABILITY BENEFITS AETNA SMALL GROUP DISABILITY PLAN OPTIONS Available with an Aetna Medical Plan to Groups with 2-50 Eligible Available with an Aetna Dental Plan to Groups with Eligible Available Standalone (without Medical or Dental Plans) to Groups with Eligible Short Term Benefits Plan Option 1 Plan Option 2 Plan Amount Benefits Start Accident Benefits Start Illness Maximum Benefit Period Maternity Benefit Pre-Existing Conditions Rule Actively at Work Rule Other Income Offset Integration Definition of Disability Class Schedules Choice of flat $100 increments to a Choice of flat $100 increments to a maximum of $500 weekly maximum of $500 weekly 1 Day 8 Days 8 Days 8 Days 26 Weeks 26 Weeks Maternity treated the same as any other disability Maternity treated the same as any other disability but is subject to pre-existing. If pregnant before the but is subject to pre-existing. If pregnant before the effective date, the pregnancy is not covered unless effective date, the pregnancy is not covered unless there is creditable coverage. there is creditable coverage. 3/12 3/12 Applies Applies N/A N/A Earnings Loss of 20% or more Earnings Loss of 20% or more Up to 3 classes (with a minimum requirement of 3 employees in each class) available for groups of 10 or more employees the benefit amount of the highest class cannot be more than 5 times the benefit amount of the lowest class even if only two classes are offered 3 Life and Disability products are underwritten or administered by Aetna Life Insurance Company.

5 AETNA SMALL GROUP PACKAGED LIFE AND DISABILITY PLAN OPTIONS Available with an Aetna Medical Plan to Groups with 2-50 Eligible Available with an Aetna Dental Plan to Groups with Eligible Available Standalone (without Medical or Dental Plans) to Groups with Eligible Basic Life Plan Design Low Option 1 Low Option 2 Medium Option 1 Medium Option 2 High Option Benefit Flat $10,000 Flat $15,000 Flat $20,000 Flat $25,000 Flat $50,000 Guaranteed Issue 2-9 Lives $10,000 $15,000 $20,000 $20,000 $20, Lives $10,000 $15,000 $20,000 $25,000 $50,000 Reduction Schedule Employee s Original Life Amount reduces to 65% at age 65; 40% at age 70; 25% at age 75. While the volume decreases the premium decreases but the rates do not go down. Disability Provision Premium Waiver 60 Premium Waiver 60 Premium Waiver 60 Premium Waiver 60 Premium Waiver 60 Conversion Included Included Included Included Included Accelerated Death Benefit Up to 75% of benefit, Up to 75% of benefit, Up to 75% of benefit, Up to 75% of benefit, Up to 75% of benefit, Dependent Life Spouse $5,000; AD&D Ultra AD&D Ultra Additional Features Spouse $5,000; Spouse $5,000; Spouse $5,000; Spouse $5,000; Seat Belt/Airbag, Education, Child Care, Repatriation, Coma, Total Disability, 365-Day Covered Loss Disability Plan Design Monthly Benefit Flat $500; No offsets Flat $1,000; Offsets are Workers Compensation, any State Disability Plan and Primary and Family Social Security benefits. Elimination Period 30 days 30 days 30 days 30 days 30 days Definition of Disability Own Occupation: Earnings loss of 20% or more. Own Occupation: Earnings loss of 20% or more. Own Occupation: Earnings loss of 20% or more. Own Occupation: Earnings loss of 20% or more. First 24 months of benefits: Own Occupation: Earnings Loss of 20% or more; Any reasonable occupation thereafter: 40% earnings loss. Benefit Duration 24 months 24 months 24 months 24 months 60 months Pre-Existing Condition Limitation 3/12 3/12 3/12 3/12 3/12 Types of Disability Separate Periods of Disability Mental Health/ Substance Abuse 24 months 24 months 24 months 24 months 24 months Waiver of Premium Included Included Included Included Included Other Plan Provisions Employer Contribution 2-9 Lives 100% Minimum Participation 2-9 Lives 100%; Eligibility 2-9 Lives 100% 2-9 Lives 100%; 2-9 Lives 100% 2-9 Lives 100%; 2-9 Lives 100% 2-9 Lives 100%; 2-9 Lives 100% 2-9 Lives 100%; Class Schedules 2-9 Lives: Not Available; Lives: Up to 3 classes (with a minimum requirement of 3 employees in each class) the benefit amount of the highest class cannot be more than 5 times the benefit amount of the lowest class even if only two classes are offered. Rate Guarantee 1 year 1 year 1 year 1 year 1 year Rates PEPM $8.00 $10.00 $15.00 $16.00 $

6 Limitations and Exclusions AD&D Ultra Limitations and Exclusions This coverage is only for losses caused by accidents. No benefits are payable for a loss caused or contributed to by: A bodily or mental infirmity. A disease or bacterial infection.* Medical or surgical treatment.* Suicide or attempted suicide (while sane or insane). An intentionally self-inflicted injury. A war or any act of war (declared or not declared). Voluntary inhalation of poisonous gases. Commission of or attempt to commit a criminal act. Use of alcohol, intoxicants or drugs, except as prescribed by a physician. An accident in which the blood alcohol level of the operator of a motor vehicle meets or exceeds the level at which intoxication would be presumed under the law of the state where the accident occurred shall be deemed to be caused by the use of alcohol. Air or space travel. This does not apply if a person is a passenger, with no duties at all, on an aircraft being used only to carry passengers (with or without cargo). Disability Limitations and Exclusions No benefits are payable if the disability: Is due to intentionally self-inflicted injury (while sane or insane). Results from you committing, or attempting to commit, a criminal act. Is due to insurrection, rebellion or taking part in a riot or civil commotion. Is due to war or any act of war (declared or not declared). Is not a non-occupational disease. (STD only) Is not a non-occupational injury. (STD only) Results from driving an automobile while intoxicated. ( Intoxicated means: the blood alcohol level of the driver of the automobile meets or exceeds the level at which intoxication would be presumed under the law of the state where the accident occurred.) On any day during a period of disability that a person is confined in a penal or correctional institution for conviction of a criminal or other public offense, the person will not be deemed to be disabled and no benefits will be payable. No benefit is payable for any disability that occurs during the first 12 months of coverage and is due to a pre-existing condition for which the member was diagnosed, treated or received services, treatment, drugs or medicines three (3) months prior to coverage effective date. *These do not apply if the loss is caused by an infection that results directly from the injury or surgery needed because of the injury. The injury must not be one that is excluded by the terms of the contract. 5

7 Notes

8 This material is for information only and is not an offer or invitation to contract. An application must be completed to obtain coverage. Rates and benefits may vary by location. Life and disability insurance plans contain exclusions and limitations. Plan features and availability may vary by location and group size. Health information programs provide general health information and are not a substitute for diagnosis or treatment by a physician or other health care professional. Programs provide access to discounted prices and are NOT insured benefits. PlanForYourHealth is a public education program from Aetna and The Financial Planning Association. Providers are independent contractors and not agents of Aetna. provider participation may change without notice. Aetna does not provide care or guarantee access to health services. Not all disability services are covered. See plan documents for a complete description of benefits, exclusions, limitations and conditions of coverage. Plan features are subject to change. Information is subject to change NC A (9/07) 2007 Aetna Inc.